摘要目的 评价飞秒激光制瓣LASIK矫正近视合并高度散光的短期疗效.方法 回顾性病例研究.收集接受飞秒激光制瓣LASIK的高度散光患者53例(76眼)(柱镜≥-2.0 D),所有患者均有完整的术前检查和术后3个月的检查结果,将术前和术后的屈光度转化为屈光度的极值参数,对相关指标进行计算分析和评估,数据分析采用配对t检验和线性回归分析.结果 术后3个月平均球镜度为(+0.37±0.50)D,平均柱镜度为(-0.57±0.44)D.等效球镜度和术前预留等效球镜度之间的偏差是(+0.18±0.48)D,散光欠矫了(0.30±0.43)D(t=6.17,P＜0.01),手术诱发的平均柱镜旋转量是(0.09±0.34)D(t=2.22,P＜0.05),预期矫正等效球镜度和实际矫正等效球镜度之间显著相关(R2=0.96).结论 飞秒激光制瓣LASIK矫正近视合并高度散光的短期疗效确切,预测性好,但散光有轻度的欠矫,柱镜发生了轻微的逆时针旋转.

abstractsObjective To evaluate the short-term outcomes after femtosecond laser-assisted laser in situ keratomileusis (FEMTO-LASIK) in highly astigmatic myopes.Methods Eyes with more than 2.0 diopters (D) of astigmatism were identified from patient records.The mean preoperative cylinder was-2.45±0.62 DC in myopic eyes.Patients were examined preoperatively and 3 months postoperatively.Laser in situ keratomileusis was performed with a WaveLight FS200 femtosecond laser and a WaveLight eye-Qexcimer laser.Preoperative and postoperative refractions were converted to vector values.Induced torsion of the cylinder axis and the correction achieved for sphere and cylinder were determined.Data were analyzed using a paired t test and linear regression.Results After 3 months,the mean sphere was +0.37±0.50 D in myopic eyes and the mean cylinder was-0.57±0.44 D.Spherical equivalent (SE) correction was +0.18±0.48 D from the target value.Astigmatism was undercorrected by-0.30±0.43 D (t=6.17,P＜0.01),and the mean induced torsion of the axis was 0.09±0.34 radians (t=2.22,P＜0.05).Attempted and achieved SE corrections were highly correlated (R2=0.96).Conclusion Laser in situ keratomileusis in highly astigmatic eyes can precisely correct SE refraction but leads to astigmatic undercorrection.A slight counterclockwise torsion of the cylinder axis was induced.